ELISPOT检测技术在儿童结核病诊断中的应用  

Evaluation of ELISPOT Assay for Tuberculosis Diagnosis in Children

作　　者：孙琳[1] 焦伟伟[1] 赵顺英[2] 李兆娜[1] 胡英慧[3] 冯雪莉[3] 李惠民[2] 迟巍[2] 江沁波[3] 江载芳[1] 申阿东[1] 

机构地区：[1]首都医科大学附属北京儿童医院儿科研究所中心实验室,北京100045 [2]首都医科大学附属北京儿童医院儿科研究所感染科,北京100045 [3]首都医科大学附属北京儿童医院儿科研究所呼吸科,北京100045

出　　处：《标记免疫分析与临床》2008年第6期349-353,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：为了评价ELISPOT试验在儿童结核病诊断中的应用价值,采用以结核分枝杆菌特异性蛋白ESAT-6和CFP-10(cu lture filtrate prote in-10)为抗原的ELISPOT试验技术,检测了42例非结核性肺疾病患儿和27例活动性结核病患儿体内特异性T淋巴细胞分泌的γ-干扰素水平,评价其在儿童活动性结核病和潜伏结核感染中的敏感性和特异性,并将结果与结核菌素皮试结果(PPD)进行比较;同时分析了该试验的各影响因素。结果显示,ELIS-POT试验的敏感性为88.9%,特异性(97.6%)高于PPD(81%,P(0.05);与PPD试验结果结合分析,其诊断阳性率为96.3%。此外,ELISPOT试验结果与性别、年龄、BCG接种史、结核病接触史、机体免疫状态、PPD直径和感染部位等影响因素之间的相关性进行了初步探讨。实验结果提示ELISPOT试验适宜作为儿童PPD试验初筛后结核病诊断的重要辅助工具。To evaluate the ELISPOT assay in the rapid detection of tuberculosis in children, two M. tuberculosis-specific proteins, ESAT-6 and CFP-10, stand out as suitable antigens that induce a IFN-γ- secreting T-cell-mediated immune response to infection. The sensitivity and specificity of the assay were evaluated in total 27 children active tuberculosis and 42 nontuberculosis with other pulmonary disease, and the results were compared with tuberculin skin test（TST）. Some of the influential factors were analyzed. The sensitivity of the assay is 88.9%, and the specificity （97.6%） is higher than TST（81%, P 〈0.05 ）. The positive rates were 96.3% after the combination of ELISPOT assay and TST. The resuits of the ELISPOT assay had little relationship with sex, age, BCG vaccination status, history of exposure to source case, immunity state, induration diameter of PPD, infection position. The ELISPOT assay could be used as an importantly assistant tool to clinical diagnosis in children after PPD.

关 键 词：结核病 诊断 ELISPOT ESAT-6 CFP-10 

分 类 号：R725.1[医药卫生—儿科]